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3w ago

DOJ Files Lawsuit Against Health Insurers and Brokers Over Medicare Kickback Scheme

The complaint alleges illegal payments to steer Medicare Advantage enrollments and discrimination against disabled beneficiaries.

This Thursday, June 1, 2017, photo, shows a sign on the campus of the Aetna headquarters, in Hartford, Conn.
Signage for Humana Inc. is pictured at a health facility in Queens, New York City, U.S., November 30, 2021. REUTERS/Andrew Kelly

Overview

  • The Department of Justice filed a False Claims Act complaint on May 1, 2025, against Aetna, Elevance Health, Humana, and three broker firms: eHealth, GoHealth, and SelectQuote.
  • The lawsuit accuses insurers of paying hundreds of millions in illegal kickbacks from 2016 to 2021 to brokers in exchange for enrolling beneficiaries into their Medicare Advantage plans.
  • Brokers allegedly prioritized high-commission plans over suitability for beneficiaries, steering seniors toward plans that benefited insurers financially.
  • Aetna and Humana are further accused of conspiring with brokers to discriminate against disabled Medicare beneficiaries by threatening to withhold kickbacks.
  • If found liable, the defendants could face treble damages and penalties under the False Claims Act, with the case now pending in federal court in Massachusetts.